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Remote Utilization Review Manager Jobs in Minnetonka, MN

TPAC Underwriters

Clinical Risk Nurse

Blaine, MN · On-site +1

$90K - $120K/yr

This is a remote or hybrid, full-time position located in our Blaine, MN office depending on ... management referrals, centers of excellence, and utilization review opportunities * Serve as a ...

Huntington

Credit Review Team Leader Sr

Minnetonka, MN · On-site +1

$125K - $255K/yr

The Credit Review Team Leader Sr. has a proven track record in a Credit Review management role or ... Remote roles will also have the opportunity to come together in our offices for moments that matter.

Huntington

Credit Review Team Leader Sr

Minnetonka, MN · On-site +1

$125K - $255K/yr

The Credit Review Team Leader Sr. has a proven track record in a Credit Review management role or ... Remote roles will also have the opportunity to come together in our offices for moments that matter.

Optomec Inc

Support Manager

Saint Paul, MN · Remote

... utilization, CSAT). * Lead post-incident reviews for P1/P2 incidents and implement corrective ... Excellent remote customer-facing communication skills; experience managing escalations virtually.

Allianz

Counsel | Remote

Minneapolis, MN · On-site +1

... business units and management. What you do: * Reviews, prepares and negotiates legal and ... Utilization of artificial intelligence tools and resources (e.g. generative Al). What you bring:

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All JobsUtilization Review JobsRemote Utilization Review Manager JobsRemote Utilization Review Manager Jobs in Minnetonka, MN

Remote Utilization Review Manager information

See Minnetonka, MN salary details

$39.8K

$92.8K

$170.8K

How much do remote utilization review manager jobs pay per year?

As of Sep 2, 2026, the average yearly pay for remote utilization review manager in Minnetonka, MN is $92,795.00, according to ZipRecruiter salary data. Most workers in this role earn between $60,700.00 and $111,600.00 per year, depending on experience, location, and employer.

What is a remote utilization review manager?

A Remote Utilization Review Manager is a healthcare professional responsible for overseeing the review of medical services and determining the necessity, appropriateness, and efficiency of those services from a remote location. They ensure that healthcare providers comply with guidelines and that patients receive appropriate care without unnecessary procedures. These managers work with clinical teams, insurance companies, and regulatory agencies to optimize patient outcomes and manage healthcare costs. Working remotely allows them to perform these duties using digital health records and telecommunication tools.

What are the key skills and qualifications needed to thrive as a remote utilization review manager?

To thrive as a Remote Utilization Review Manager, you need expertise in healthcare management, case review, and regulatory compliance, typically supported by a nursing degree (RN or BSN) and relevant certifications such as CCM or URAC. Familiarity with utilization management software, electronic health records (EHRs), and payer systems is essential. Strong analytical thinking, attention to detail, and excellent communication skills help navigate complex cases and collaborate with clinical teams and insurers. These skills ensure effective resource utilization, regulatory adherence, and optimal patient outcomes in a remote healthcare environment.

What are some common challenges faced by a remote utilization review manager, and how can they be addressed?

A Remote Utilization Review Manager often encounters challenges such as maintaining effective communication with clinical teams, ensuring timely and accurate reviews, and staying updated with changing regulations and payer requirements. To address these, it's important to leverage secure collaborative platforms, establish clear workflows, and participate in ongoing training. Building strong relationships with team members and regularly reviewing protocols also help in overcoming remote work hurdles and ensuring compliance and efficiency.

What is the difference between Remote Utilization Review Manager vs Remote Utilization Review Nurse?

AspectRemote Utilization Review ManagerRemote Utilization Review Nurse
CredentialsTypically requires a nursing license, certifications like URAC or AAPC, and management experienceLicensed Registered Nurse (RN) with utilization review certification often preferred
Work EnvironmentOversees review teams, manages processes, and ensures compliance remotelyPerforms case reviews, assesses medical necessity, and documents findings remotely
Employer & Industry UsageHealth insurance companies, third-party administrators, healthcare organizations

The Remote Utilization Review Manager focuses on overseeing review teams and managing processes, while the Remote Utilization Review Nurse conducts case assessments and medical necessity reviews. Both roles require nursing credentials and are integral to healthcare utilization management, but differ in responsibilities and leadership levels.

What are popular job titles related to Remote Utilization Review Manager jobs in Minnetonka, MN?

For Remote Utilization Review Manager jobs in Minnetonka, MN, the most frequently searched job titles are:

What job categories do people searching Remote Utilization Review Manager jobs in Minnetonka, MN look for?

The top searched job categories for Remote Utilization Review Manager jobs in Minnetonka, MN are:

What cities near Minnetonka, MN are hiring for Remote Utilization Review Manager jobs?

Cities near Minnetonka, MN with the most Remote Utilization Review Manager job openings:

Remote Utilization Review Manager jobs near you

Diagnostic Radiology- Medical Record Reviewer

Dane Street, LLC

Minneapolis, MN • Remote

Full-time

Re-posted 19 days ago

Job description

As Physician Reviewer/Advisor for Independent Medical Exams (IME), you will utilize clinical expertise and reviews insurance appeals, and prospective and retrospective claims. The Physician Reviewer will provide an interpretation of the medical necessity of services provided by other healthcare professionals in compliance with client-specific policies, nationally recognized evidence-based guidelines, and standards of care.

MAJOR DUTIES AND RESPONSIBILITIES:

    • Reviews all medical records and addresses each question posed by the client, utilizing client-specific criteria or other nationally recognized evidence-based criteria
    • Ensures that the rationale for the determination is clear, concise, and contains adequate supporting documentation to substantiate the decision
    • Identifies, critiques, and utilizes current criteria and resources such as national, state, and professional association guidelines and peer-reviewed literature that support sound and objective decision-making and rationales in reviews; refrains from using case studies, cohorts, and the like to make decisions due to their limited sample sizes
    • Provides copies of any criteria utilized in a review with the report promptly
    • Returns cases on or before the due date and time
    • Makes telephone calls as mandated by the state and/or client specifics
    • Maintains proper credentialing, state licenses, and any special certifications or requirements necessary to perform the job
    • Performs other duties as assigned, including identifying and responding to quality assurance issues, complaints, regulatory issues, depositions, court appearances, or audits
    • Board certification required, active practice required

Please be aware that, in the interest of all parties, Dane Street won't conduct interviews via text or request checks from candidates for any reason, including the purchase of equipment. 

Benefits

Benefits

  • Robust opportunity for supplemental income
  • Schedule flexibility and predictable work hours - You choose services and case types, dictate volume, and conduct exams and reviews based on your schedule availability
  • No doctor/patient relationship is established and no treatment is provided. These are advisory-only opinions.
  • Enhanced industry expertise strengthening your medical practice with medical necessity and utilization review/management expertise
  • Expanded credentials as an expert in Independent Medical Exams and physician advisor services
  • Fully prepped cases, streamlined case flow, transcription services at no cost, and user-friendly work portal